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The  American 
Hospital  for  Women  and 
Children  in  Madura 


1 


By  Rf.v.  E.  S.  Holton 


WOMAN’S  HOARD  OF  MISSIONS 

14  BEACON  STREET 
BOSTON 

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THE  AMERICAN  HOSPITAL  FOR  WOMEN 


AND  CHILDREN  IN  MADURA 
Dr.  Harriet  E.  Parker 


By  Rev.  E.  S.  Holton 


THE  ancient  city  of  Madura  is  on  the  tenth  degree  of  north 
latitude  about  150  miles  north  of  Cape  Comorin.  The 
word  “Madura”  means  sweetness,  from  a dew  of  honey 
fabled  to  have  once  settled  there.  But  to  thousands  of  women 
during  the  past  twenty  years  it  has  meant  relief  from  pain,  suffer- 
ing and  numbing  fear,  since  it  is  there  that  the  little  white  Doctor 
Ammarl  is  ready  night  or  day  to  bring  to  bear  upon  any  sort  of 
physical  ill  the  skill  of  her  slender  fingers,  the  experience  of  an 
active  brain  and  the  courage  of  a dauntless  heart. 

There  are  hospitals  for  women  in  Madras  and  at  Vellore  in 
the  North  Arcot  district,  150  and  300  miles  north  of  Madura. 
But  they  are  as  impossible  for  the  bulk  of  the  people  that  have 
need  as  the  hospitals  in  New  York  would  be  for  the  natives  of 
Virginia.  In  the  districts  of  Trichinopoly,  Madura,  Ramnad. 
Tinnevelley  and  Travancore,  a region  about  half  as  large  as 
New  England  and  with  a population  of  fifteen  millions  or  twice 
that  of  New  England,  there  is  no  other  mission  hospital  for 
women  and  no  other  woman  doctor.  There  are  government 
or  municipal  hospitals  for  women  and  children,  but  these  are 
staffed  with  male  doctors;  since  the  drain  of  the  war  many  of 
these  are  Indians.  Owing  to  the  seclusion  of  women  and  the 
prejudices  and  customs  of  the  land  only  the  very  poorest  women 
or  those  in  the  immediate  vicinity  will  come  to  such  a hospital. 

Medical  work  for  women  was  begun  in  Madura  city  by  the 
late  Mrs.  S.  B.  Capron  and  through  her  earnest  endeavors  a 
dispensary  was  built  and  Miss  Pauline  M.  Root,  M.D.,  was  sent 
out  by  the  Woman’s  Board  in  1885.  She  began  the  erection  of 
a small,  two-story  hospital  but  left  India  in  1891  before  its 
completion.  It  was  dedicated  in  1893.  Dr.  Harriet  E.  Parker 
was  appointed  as  her  successor  and  arrived  early  in  1896.  Dr. 
Parker  was  born  in  Putney,  Vermont.  She  studied  at  Smith 
College,  1885-1887,  and  is  a graduate  of  the  Woman’s  Medical 
College  of  Philadelphia. 


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The  city  of  Madura  was  built  originally  as  a fort  with  the 
great  Hindu  temple  of  Meenachi,  the  Fish-eyed  Goddess,  at  its 
center.  A second  center  is  the  great  palace  of  Tirumal  Naiyak 
about  one-half  mile  southeast  of  the  temple.  The  American 
Mission  compound  is  due  east  of  the  palace,  with  only  one 
narrow  block  of  one-story  houses  between.  Thus  the  new 
hospital  for  women  and  children  is  built  on  the  corner  of  the 
compound  immediately  opposite  the  main  entrance  of  the  fine 
old  palace  that  Government  has  repaired,  restored  and  taken 
over  for  public  offices. 

The  new  hospital,  which  is  of  brick  and  steel  with  hollow  tiled 
floors,  is  in  the  shape  of  the  letter  E,  with  the  front  towards  the 
West.  It  is  two  stories  high  and  the  foundations  will  permit  a 
third  story  whenever  that  may  be  needed.  The  government 
generously  made  a half-grant  on  the  cost  of  the  building  and 
allowed  the  Executive  Engineer  of  the  Public  Works  Department 
to  supervise  its  construction.  The  Mission  put  the  erection  of 
the  buildings  into  the  capable  and  experienced  hands  of  its 
treasurer,  Mr.  James  H.  Lawson,  and  whenever  he  has  any  dis- 
agreement with  the  contractors  over  the  quality  of  either  mate- 
rials or  workmanship  the  decision  of  the  Executive  Engineer  is 
final.  The  hospital  plant  has  also  been  greatly  benefited  by  the 
generous  counsel  of  a fine  Christian  gentleman,  Mr.  S.  D.  Pears 
of  Madras,  until  recently  chief  engineer  to  the  government  in 
the  department  of  Public  Works.  All  the  plans  and  construc- 
tion of  modern  hospitals  in  Southern  India,  civil  and  mission, 
were  carefully  considered  while  our  plans  were  being  drawn  and 
revised. 

The  hospital  is  so  built  that  it  can  easily  be  kept  clean  and 
disinfected  without  and  within,  below  and  above.  The  stairs 
are  broad  and  of  easy  grade  so  that  stretcher  cases  may  be 
moved  up  and  down  easily.  One  wing  is  reserved  for  maternity 
cases.  There  is  an  isolation  ward  and  one  for  convalescents. 
The  morgue  has  a building  quite  apart  by  itself  as  far  removed 
as  possible  from  all  others.  A septic  tank  is  being  installed. 
In  a land  where  there  is  such  strictness  in  the  observance  of 
caste  regulations  the  diet-kitchen  arrangements  are  not  simple. 
A Brahman  woman  or  child  may  eat  only  food  prepared  by  a 
Brahman  cook  in  quarters  not  used  by  lower  castes,  so  a separate 
kitchen  is  supplied  for  them.  The  Sourashta  or  Silk-weaver 


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caste  has  endowed  a ward  and  a kitchen  for  the  use  of  its  own 
people. 

The  Nurses’  Home  is  in  a long  wing  at  right  angles  to  the 
Doctor’s  bungalow,  fifty  or  sixty  yards  to  the  rear  of  the  hos- 
pital. The  training  of  nurses  is  an  important  part  of  the  work 
of  the  hospital  and  candidates  are  sent  by  Missions  in  other 
districts.  In  a country  of  such  dense  ignorance  and  gross  super- 
stition very  little  dependence  can  be  placed  upon  the  intelligence 
or  judgment  of  either  the  patients  or  their  attendant  relatives. 
Instructions  are  but  imperfectly  understood  and  are  not  thought 
worth  the  trouble  of  remembering  or  obeying.  The  magic 
Western  medicine  is  the  thing.  If  a little  does  good,  more  will 
do  it  quicker  and  better  and  allow  the  patient  the  sooner  to  get 
back  to  a festival,  funeral,  wedding,  or  to  the  domestic  tasks 
in  house  or  field.  A medicine  may  be  prescribed  for  external 
use  only,  but  the  pain  is  inside  and  the  magic  can  get  to  work 
sooner  and  more  effectively,  it  is  thought,  if  put  within — often 
with  surprising  and  disappointing  results.  Moreover  the  Dra- 
vidian  ideas  of  sanitation  or  even  of  simple  cleanliness  are  almost 
always  rudimentary  and  hostile  to  any  improvement  in  the 
patient.  So  while  a relative  or  two  has  to  be  allowed  to  stay  by 
the  patient  to  help  care  for  her  and  to  reassure  her  timid  mind 
in  strange  surroundings,  a trained  nurse  has  to  be  in  constant 
attendance  to  see  that  the  doctor’s  orders  as  to  rest,  medicine 
and  food  are  obeyed.  A common  danger  is  that  a zealous 
friend  will  smuggle  in  bazaar-food,  long-cooked  and  exposed  to 
flies,  dust  and  indiscriminate  handling — often  of  the  utmost 
danger  to  the  patient,  especially  in  the  time  of  epidemic  cholera. 

India  is  yet  a century  from  the  general  acceptance  of  the  germ- 
theory  of  disease.  It  is  much  simpler  to  believe  that  Kali- 
Amman,  the  smallpox  goddess,  is  angry  and  demands  victims 
rather  than  that  germs  from  the  patients  cause  others  to  be  ill! 
Garlands  across  the  street  and  sacrifices  to  her  idol  are  to  their 
minds  much  more  useful  than  the  dreaded  vaccination.  What 
cannot  be  seen  does  not  exist,  seems  to  be  their  simple  creed. 
Such  patients  and  their  village  sympathizers  obey  hospital  rules 
generally  only  under  the  fear  of  being  sent  away.  Many  are 
the  anxieties  of  the  doctor  lest  bandages  be  removed  too  soon 
because  uncomfortable,  or  patients  insist  upon  leaving  pre- 
maturely because  homesick  or  tired  of  restraint.  Too  often  any 


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reason  save  the  right  one  is  given  when  a case  thus  turns  out 
unfavorably.  But  experience  is  a dear  teacher  and  a good  part 
of  the  nurses’  work  is  to  warn  obdurate  patients  of  the  dire 
results  of  disobeying  what  the  Doctor  Ammarl  has  said. 

India  is  a land  of  such  brilliant  sunshine  and  of  so  very  little 
protection  to  the  eyes  from  glare,  dust  and  infection  from  the 
minute  swarming  eye-flies,  eager  for  the  moisture  of  neglected 
eyes,  noses,  and  mouths,  that  eye-troubles  are  very  common, 
ranging  from  ophthalmia  or  “country  sore-eyes”  to  glaucoma, 
granulated  lids  and  cataract. 

After  harvest  time  the  women  and  girls  walking  bare-footed 
over  the  woody  stubble  cut  their  feet  badly  and  the  wounds 
bound  up  with  soiled  rags  often  become  infected  sores.  Scanty 
and  improper  food  often  aggravate  what  would  be  otherwise 
simple  cases.  Malignant  ulcers  often  result  from  unclean  lives. 
Reliance  upon  quack  doctors,  with  their  worse  than  useless 
remedies  and  incantations,  often  result  in  a patient  coming 
either  too  late  or  needlessly  ill  to  the  place  where  alone  skill  and 
the  right  remedies  are  available. 

But  in  this  respect  conditions  are  steadily  improving.  With 
thirty  or  forty  thousand  treatments  a year  or  possibly  twelve 
thousand  separate  patients,  ideas  and  treatments  learned,  or  at 
least  partially  understood,  while  in  the  hospital,  are  carried  back 
to  their  homes  by  patients  who  have  been  helped.  These  new 
ideas  are  given  currency  at  the  village  well,  at  the  community 
threshing-floor,  or  during  the  long  walks  to  the  weekly  markets 
where  grain  and  fuel  are  taken  to  exchange  for  the  week’s  supply 
of  curry  stuffs  and  oil.  The  Bible-women  assigned  to  the  hos- 
pital tell  the  Gospel  message  to  the  patients  waiting  at  the 
dispensary  for  their  treatment  and  mingle  freely  with  the  con- 
valescents. So  the  knowledge  of  the  “new  way”  is  brought  to 
thousands  of  lives  through  the  ministry  of  suffering. 

Some  peculiar  ideas  are  current  among  the  people.  Often  chil- 
dren are  to  be  seen  with  three  horizontal  scars  across  the  abdomen; 
these  show  that  during  an  attack  of  colic  the  sufferer  was  branded 
with  a hot  iron.  She  recovered;  post  hoc  ergo  propter  hoc. 
Among  the  Romanists  this  branding  is  usually  done  in  the  form 
of  the  cross  or  sometimes  by  four  dots  on  forehead,  chin,  and 
both  cheeks.  An  ancient  dame  comes  along  with  a great  recital 
of  ills  and  ailments,  from  wandering  pains  and  sleeplessness  to 


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coolness  of  the  blood  and  cca  sort  of  a kind  of  feeling”  winding 
up  with  a rat-bite. 

“When  were  you  bitten?”  promptly  queries  the  doctor. 

“Seven  years  ago  last  mango  time,”  the  dame  replies.  And  it 
appears  that  as  many  ills  spring  from  the  bite  of  a rat  as  from 
the  breaking  of  a looking  glass  in  more  enlightened  lands. 

One  day,  out  in  a distant  village,  a farmer  brought  his  mare 
with  both  eyes  blinded  by  cataract  and  his  old  sister  with  two 
joints  missing  from  her  middle  finger  ever  since  she  was  born 
and  asked  that  both  be  made  whole!  An  old  man  comes  and 
drops  dejectedly  at  the  door  step  and  when  asked  his  ailment 
he  says,  “Butthi  illai!”  (I  have  no  sense).  While  the  doctor 
has  the  greatest  sympathy  with  his  need  the  pharmacopeia  lists 
no  remedy  for  his  cure. 

The  doctor  in  India  meets  many  abnormal  growths  and  un- 
usual perversions  of  Nature’s  orderly  ways;  but  their  recital 
would  be  more  appropriate  in  a medical  journal.  One  inter- 
esting disease,  known  the  world  over  as  “the  Madura  foot”  is 
peculiar  to  the  district.  It  is  a form  of  elephantiasis  where,  first 
in  the  foot  then  the  ankle,  but  never  higher  than  the  knee,  the 
foot  swells  until  it  is  the  size  of  a twelve-quart  pail  and  the  toes 
are  swallowed  up  until  they  appear  to  be  but  warts.  There  is 
no  remedy  for  it  but  amputation;  ordinarily  the  sufferer  endures 
the  burden  for  a long  time  before  willing  to  submit  to  treatment. 

The  Visitors’  Book,  maintained  at  the  hospital  for  officials 
and  others  to  record  their  impressions  of  its  work,  has  many 
interesting  records.  Some  of  the  most  flattering  were  written 
by  the  governors  of  the  Madras  Presidency — Lord  Wenlock,  Sir 
Arthur  Havelock,  Lord  Ampthill,  Baron  Carmichael  and  Lord 
Pentland,  often  by  their  Ladyships  as  well.  The  Surgeons 
General  and  district  medical  and  sanitary  officers,  while  pointing 
out  occasional  lack  of  equipment,  have  uniformly  praised  the 
good  work  they  have  found  done. 

Both  the  Madura  Municipality  and  the  District  Board  have 
generously  supplemented  the  Government’s  grants-in-aid  by 
annual  donations  from  their  budgets.  The  Lessees  of  the 
Sigaganga  Zemindari  have  for  years  made  an  annual  grant  to 
the  Hospital  from  their  Mahimai  Fund  which  is  a regular  portion 
of  their  yearly  income  devoted  to  charity  and  religion.  But  all 
these  grants  total  only  about  one-sixth  of  the  hospital’s  yearly 


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expenses.  This  means  that,  in  addition  to  the  doctor’s  consti- 
tutional unwillingness  to  miss  a single  opportunity  to  save  life 
or  alleviate  pain,  there  is  added  this  stress  of  supplementing  the 
hospital’s  income  by  outside  practice. 

Until  Dr.  Parker  was  able  to  replace  her  horse  and  carriage 
some  four  years  ago  with  a Ford  car,  she  was  extremely  for- 
tunate if  an  emergency  call  took  her  most  of  the  way  by  railway. 
Only  very  rarely  was  the  husband  or  father  of  the  patient  able 
to  send  his  own  car  or  hire  a reliable  one.  The  doctor  has  had 
many  experiences  with  ill-found  cars,  balky  or  under-fed  jutka 
ponies,  and  long  journeys  over  rough  country  roads  in  bullock 
carts  with  a cruising  speed  of  two  miles  an  hour.  A tiffin-basket 
and  thermos  flask,  or'  a humble  earthenware  water  jar,  were 
necessary  parts  of  her  equipment  along  with  instrument  bag, 
medicine  chest,  toilet  case,  and,  if  the  conveyance  permitted,  a 
nurse.  The  car  has  more  than  doubled  her  effective  radius 
beside  allowing  her  many  more  nights  of  sleep  at  home.  A new 
one  should  be  supplied  soon  to  replace  the  much-used  old  one. 

Many  people  living  in  remote  parts  of  the  District  never  have 
seen  a railway  train,  a motor  car,  or  a horse-drawn  vehicle. 
Such  folk  learn  to  suffer  uncomplainingly  and  never  realize  that 
by  a few  miles  or  hours  of  journey  they  could  gain  relief  for  them- 
selves, their  wives  or  children.  Dr.  Parker  enjoys  nothing 
better  than  to  go  on  a medical  tour  to  visit  such  regions.  Us- 
ually she  joins  with  some  district  missionary  who  can  furnish  the 
necessary  tents  and  transportation  Notice  is  sent  on  before 
to  the  weekly  market  or  to  some  central  village  that  on  a given 
date  the  white  Doctor  Ammarl  is  coming  and  will  freely  treat  all 
pain  and  illness.  Hundreds  will  come,  men,  women  and  chil- 
dren, and  gather  under  the  trees  near  her  tent;  the  missionary 
and  his  helpers  will  preach  to  them  while  awaiting  their  turn 
with  the  doctor.  Scores  of  minor  troubles  are  relieved  imme- 
diately; the  severer  cases  are  sometimes  persuaded  to  make  the 
long  journey  to  the  hospital  where  they  may  have  the  further 
care  that  is  necessary. 

One  of  the  most  terrible  diseases  of  India  is  leprosy,  the  only 
one  that  Dr.  Parker  confesses  she  fears;  so  it  was  characteristic 
of  her  to  volunteer  to  open  an  asylum  for  those  afflicted  with  this 
malady  when  there  seemed  no  other  way  to  secure  one.  Under 
the  easy  rule  of  England  the  attendance  is  purely  voluntary; 


great  numbers  prefer  to  haunt  the  cities  and  large  towns,  or 
beat  their  way  from  shrine  to  shrine,  festival  to  festival,  to 
gather  the  generous  alms  which  it  is  a part  of  the  Hindu  religion 
to  bestow  indiscriminately.  The  Edinburgh  Leper  Aid  Society, 
the  Government  and  the  Sivagange  Zemindari  gave  grants-in-aid 
to  erect  the  necessary  buildings  and  sink  the  wells  at  Daiyapuram 
(Village  of  Mercy)  on  a wide,  wind-swept,  treeless  plateau  a 
mile  out  of  Manamadura.  There  for  ten  years  a growing  work 
of  mercy  and  healing  has  been  carried  on. 

Strange  as  it  may  seem  the  American  army  surgeons  in  the 
Philippines  discovered,  used  and  reported  a cure  for  leprosy — 
chanmoogra-oil — which  injected  intraveinously  has  the  power 
to  arrest  the  ravages  of  the  disease.  Dr.  Parker  is  very  reserved 
in  her  claims  as  to  results  obtained,  but  when  the  disease  has  not 
advanced  too  far  before  treatment  is  begun,  most  cases  show 
marked  improvement;  many  have  been  sent  back  to  their  homes 
without  any  signs  of  the  disease  and  without  recrudescence. 
Many  a sufferer  has  found  the  Great  Physician  and  entered  into 
a new  life  through  the  ministry  to  the  body,  mind,  and  soul  at 
Daiyapuram  and,  like  the  lepers  of  old,  have  gone  back  to  their 
homes  to  witness  to  His  power  and  grace. 

This  institution  requires  a visit  at  least  once  each  week  by  the 
doctor-,  involving  a thirty-mile  railway  journey  for  herself  and  a 
nurse,  with  two  miles  by  bullock  cart,  and  the  return  journey 
late  the  same  night.  The  physical  labor  of  giving  one  hundred 
or  more  sterilized  intraveinous  injections  at  one  clinic  is  in  itself 
a great  task.  But  with  the  exception  of  the  American  missionary 
nurse  the  doctor  has  never  entrusted  them  to  anyone  else.  The 
utmost  precautions  as  to  dress  and  contact  have  to  be  observed 
to  prevent  contagion  that  would  endanger  herself  and  others; 
this  makes  an  added  strain. 

There  remains  the  Birds’  Nest,  the  doctor’s  one  diversion.  It 
is  really  a private  orphanage  which  has  grown  out  of  the  con- 
junction of  the  unloved  and  abandoned  babies  and  the  doctor’s 
tender  heart.  All  are  legally  adopted  by  the  doctor.  Only  she 
herself  can  tell  how  many  have  learned  to  call  her  “Mother- 
Doctor”  in  the  past  twenty  years  that  she  has  had  a residence 
outside  the  hospital  building  itself.  Several  have  succumbed 
to  starvation  or  to  the  diseases  which  they  had  suffered  before 
they  came  under  her  care.  Some  had  all  too  poor  a start  in 


9 


their  ill-assorted  parentage  and  could  not  weather  the  usual  ills 
of  childhood,  even  though  the  utmost  care  was  lavished  upon 
them.  Without  actual  count  a casual  friend  would  say  that 
they  number  now  about  twenty,  not  including  one  of  the  eldest. 
Miss  Grace  Kennett,  who,  in  1918,  returned  from  her  medical 
studies  in  Madras  a licensed  practitioner.  She  is  proving  to  be 
an  immense  help  to  the  doctor  in  the  care  of  the  hospital.  Nor 
does  it  include  Compounder  Margaret,  plump,  smiling  and 
efficient,  a great  help  in  shepherding  the  little  flock  of  Birds’ 
Nesters  who  might  otherwise  overwhelm  the  doctor  while  off 
duty  and  relaxing  in  the  midst  of  her  happy,  bare-footed,  smiling 
family. 

The  Nest  itself  is  a series  of  rooms  at  the  rear  of  the  doctor’s 
bungalow  where  a matron  cares  for  the  children  as  they  eat, 
play  and  sleep  on  the  floor  in  true  Indian  style.  All  attend  the 
day  school  from  earliest  school-going  age,  and  such  as  can  benefit 
by  it  are  sent  to  the  higher  schools  to  fit  them  for  useful  lives. 
Two  of  the  younger  boys  are  albinoes  with  pinkish  white  skins 
and  weak  eyes  that  will  never  have  normal  vision.  It  is  natural 
from  the  prejudice  of  the  people  against  girls  that  in  the  Birds’ 
Nest  the  girls  outnumber  the  boys  about  three  to  one. 

When  the  record  of  India’s  redemption  is  completed  it  may 
prove  that  the  little  Doctor  Ammarl  with  her  Hospital,, Leper 
Asylum,  Birds’  Nest  and  medical  itineracies  out  in  the  neglected 
corners  of  the  District,  will  have  counted  for  more  than  some  of 
the  better  known  and  more  amply  financed  agencies.  It  is  difficult 
to  imagine  a work  where  an  investment  of  help  will  yield  larger 
returns. 

Note:  Rev.  Mr.  Holton  is  a missionary  of  the  American  Board  in  the  Madura 
Mission  who  has  first-hand  knowledge  of  the  Hospital  at  Madura  and  of  Dr. 
Parker's  self-denying  work. 

The  Editor. 


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